Department of Anesthesiology.
Department of Electronic Engineering, San Buenaventura University, Cali, Colombia.
J Neurosurg Anesthesiol. 2022 Oct 1;34(4):419-423. doi: 10.1097/ANA.0000000000000780. Epub 2021 Jun 7.
The aim of this observational study was to determine whether bilateral bispectral index (BIS) monitoring can detect seizures in epileptic patients.
Four-channel frontal BIS monitoring and standard 40-channel electroencephalography monitoring were conducted in epileptic patients undergoing evaluation for epilepsy surgery. The BIS numerical value, signal quality index, electromyography, suppression ratio, and color density spectral array were continuously recorded. In patients with electroencephalography-confirmed seizures, the mean value and trend (slope of linear regression) of bilateral BIS monitor parameters were analyzed from 1 minute before to 1 minute after seizure onset.
Of 48 patients included in the study, 21 (43.8%) had at least 1 seizure. BIS numerical value was not able to detect focal or focal to bilateral tonic-clonic seizures. Considering all seizures, the only significant differences between recordings 1 minute before and 1 minute after seizure onset were a decrease in the signal quality index slope from 1 hemisphere (0.039±0.297 vs. -0.085±0.321, respectively; P =0.029) and in the mean signal quality index recorded from both hemispheres (left hemisphere: 65.775±30.599 vs. 61.032±26.285; P =0.016 and right hemisphere: 63.244±31.985 vs. 59.837±27.360; 0.029); these differences were not maintained after Hochberg adjustment for multiple comparisons. In seizures occurring during sleep, there was a change in the electromyography slope of 1 hemisphere before and after seizure onset (-0.141±0.176 vs. 0.162±0.140, respectively; P =0.038). There were variable responses in BIS parameters in the 3 patients who developed focal nonconvulsive seizure clusters.
Bilateral BIS monitoring was not able to detect the occurrence of seizures in epileptic patients.
本观察性研究旨在确定双频指数（BIS）监测是否可用于检测癫痫患者的发作。
对 48 例行癫痫手术评估的癫痫患者进行四通道额部 BIS 监测和标准的 40 通道脑电图监测。连续记录 BIS 数值、信号质量指数、肌电图、抑制比和彩色密度频谱阵列。在脑电图确认有发作的患者中，分析发作前 1 分钟至发作后 1 分钟双侧 BIS 监测参数的平均值和趋势（线性回归斜率）。
本研究共纳入 48 例患者，其中 21 例（43.8%）至少有 1 次发作。BIS 数值不能检测局灶性或局灶性双侧强直阵挛性发作。考虑到所有发作，发作前 1 分钟和发作后 1 分钟记录之间仅有的显著差异是 1 个半球的信号质量指数斜率下降（0.039±0.297 与-0.085±0.321，P=0.029）和双侧半球的平均信号质量指数记录下降（左侧半球：65.775±30.599 与 61.032±26.285，P=0.016；右侧半球：63.244±31.985 与 59.837±27.360，P=0.029）；这些差异在 Hochberg 多重比较调整后不再存在。在睡眠期间发生的发作中，发作前和发作后 1 个半球的肌电图斜率发生变化（-0.141±0.176 与 0.162±0.140，P=0.038）。3 例出现局灶性非惊厥性发作簇的患者的 BIS 参数有不同的反应。
双侧 BIS 监测不能用于检测癫痫患者的发作。
